NPIMap

Organization Active NPI

Southwest Boston Senior Services, Inc.

  • Point of Service
  • Jamaica Plain, MA
National Provider Identifier
1295869089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
SOUTHWEST BOSTON SENIOR SERVICES, INC.
Practice address
555 Amory St
Jamaica Plain, MA 02130-2652
Phone
(617) 522-6700
Fax
(617) 524-2899
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dale P. Mitchell
Title
Executive Director
Phone
(617) 522-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

555 Amory St
Jamaica Plain, MA 02130-2652

Mailing address

555 Amory St
Jamaica Plain, MA 02130-2652
Phone (617) 522-6700

Other identifiers 1

IdentifierTypeStateIssuer
1906399MedicaidMA

Other names 1

  • Ethos Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ethos4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

555 Armory St
Jamaica Plain, MA 02130
Phone (617) 383-6522

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295869089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-522-6700",
            "fax_number": "617-524-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-522-6700",
            "fax_number": "617-524-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST BOSTON SENIOR SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "617-522-6700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1906399",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ethos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.